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The Karim Centre for
Meningitis Research, Imperial College School of Medicine, Department of
Paediatrics and Neonatal Medicine, Queen Charlotte's and Chelsea
Hospital, Goldhawk Road, London W6 0XG, UK
Correspondence to: Professor Harvey, Department of Paediatrics, Imperial College School of Medicine, Hammersmith Hospital, Ducane Road, London W12 0NN, UK david.harvey{at}ic.ac.uk
Accepted 12 October
2000
OBJECTIVES
To
determine the incidence of neonatal meningitis in England and Wales.
DESIGNA national
postal survey using the British Paediatric Surveillance Unit (BPSU)
card scheme supplemented by information from other sources.
SETTINGEngland and
Wales 1996-1997.
SUBJECTSA total of
274 babies less than 28 days of age who were treated for meningitis.
RESULTSThe incidence
of neonatal meningitis in England and Wales has not changed since our
previous study in 1985-1987. However, the acute phase mortality has
fallen from 19.8% in 1985-1987 to 6.6% in this study. Group B
streptococci (42%) and Escherichia coli
(16%) remain the most common infecting microorganisms. Eight of 69 (12%) babies with group B streptococci and 4/26 (15%) with E coli died. Antibiotic regimens based on
the third generation cephalosporins, notably cefotaxime, were most
commonly used (84%). The BPSU scheme identified 72% of cases during
the study period. Most cases of viral meningitis were not reported
through the BPSU. Less than a third of samples from aseptic meningitis
were examined for viruses; 56% of these were positive.
CONCLUSIONSAlthough
the incidence of neonatal meningitis remains unchanged, mortality from
this infection has fallen significantly. If this improvement is
maintained as reflected in the level of sequelae at 5 years of age,
then the fear surrounding meningitis during the neonatal period will
have been dramatically reduced.
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